Diathermic electrode



May 9, 1933. R. H. WAFPLER 1,908,583

DIATHERMIC ELECTRODE Filed Sept. 13 1929 Fatenteel May 9, i933 auraspr-Te FCE DIATHERMIC ELECT RODE Application led September 13, 1929.Serial No. 392,296.

My present invention relates generally to surgical instruments, and hasparticular reference to a diathermic electrode.

It is a general object of my invention to provide an electrode havingfeatures of construction which render it peculiarly efficient inthediathermic treatment of internal organs, such as the bladder. Anelectrode of the character to which my invention relates is designed tobe inserted through an endoscopic tube and out of a suitably providedfenestra at the inner end of such tube.

A more particular object of my invention is to provide an electrodehaving advantageous characteristics of smallness, compactness,flexibility, and safety; and embodying a construction which permits theemployment, for diathermic purposes, of larger currents than thoseheretofore employed.

Briefly, my improved electrode comprises a relatively thin, flexible andresilient stem and a relatively enlarged head. The stem consists of acore of conducting material ensheathed in suitable insulation, and thehead consists essentially of a conducting material,

as will be readily understood.

A particular feature of my invention lies in the provision of a stemcore in the form of twist-ed wires, such construction lending greaterstrength and flexibility to the device. Another feature lies inproviding a construction wherein the head is removably applicable to thestem, thereby permitting the selective employment of that particulartype of head which is moet suitable or desirable for the particulartreatment in contemplation.

An important feature of my present invention lies in the provision of ahead which is constructed partly of conducting material and partly ofinsulating material, the structure being such that possibility ofshort-circuiting is practically eliminated. In this way, the likelihoodof injury and pain to the patient, and of impairment of smoothoperation, is greatly reduced.

Another important feature of my present invention lies in theconstruction of an electrode whose stem insulation is of such a naturethat relatively large currents may be passed through the electrode witha minimum likelihood of breakdown. Briefly, my construction consists inthe employment of a plurality of mutually telescoped insulating tubessurrounding or ensheathing the core ofthe M electrode stem. Y

For the attainment of the foregoing objects and such other objects asmay hereinafter appear or be pointed out, I have constructed a deviceembodying the features ofV Figure 3 is an enlarged longitudinalcrosssection of the electrode of Figure 2;

Figure 4 is -a longitudinal cross-section through an electrode head ofslightly different construction;

Figure 5 is a view similarl to Figure 4, illustrating a secondmodification; and

Figure 6 is an enlarged cross-sectional view taken substantially alongthe line 6-6 of Figure 3.

ln Figure l, I have shown the inner end of an endoscopic tube 10provided with the customary nose or beak 11 and a lateral fenestra l2. lhave shown a lamp 13 mounted at the forward end of the fenestra 12.

The particular construction of the endoscopic tube and its associatedparts is not essential so far as the present invention is concerned, andl have therefore eliminated all detailed showing of the customaryauXiliary construction such as the pet-cocks, the binding posts, theeyepiece, and the catheter guides. I will state, however', that theelectrode of the present invention is adapted to be passed through asuitable catheter guide so that the end thereof will emanate` from thefenestra l2, and l will state further that the employment of myelectrode is accomplished by a deflection and guidance of the forwardend of the electrode by means of a suitable catheter-deflecting device.

Thus, in Figure l, l have shown the dethe device.

flector blade 14 of a catheter-deilecting device, the movements of thisblade being controlled from the rear end of the endoscopic tube 10, andthe blade 14 being adapted to 5 bear against the forward end of theelectrode to deflect the latter in an accurate manner out of thefenestra 12 and into the particular position desired. Furthermore, itwill be understood that a suitable telescopic tube is provided withinthe endoscopic tube 10 so that the electrode may be eiiiciently guidedand applied to the desired portion of the body cavity under illuminatedvision.

I will state further that in the employment of electrodes of the presentcharacter, it is customary to utilize the endoscopic tube 10 as anindifferent electr-ode, the electric current passing through the body ofthe patient and the circuit being completed through the diseased portionwith which the electrode head is brought into contact. It is thereforeimportant, in view of theelectrical circuit just described, thatshort-,circuiting be avoided.

In Figure 3, I have illustrated an electrode wherein the stem comprisesa core 15 formed of aV pair of thin mutually twisted or Spiralled'conducting wires, preferably of Monel metal or the like. At the forwardend of this core, I attach a connector 16 which is provided in theillustrated form with a rearwardly opening bore 17 adapted to receivethe forwardv ends of the twisted wires 15.

These ends may be soldered in this bore or suitably attached to theconnector 16 in any other desired manner. The connector 16 has also beenshown provided with a forwardly projecting threaded stem 18 whichfacilitates the removable application of an electrode head such as thatshown at 19. The latter is substantially cylindrical and is provided notonly with an internally threaded bore adapted to cooperate with the stem18, but also with a rearwardly xtending skirt 5 portion 2() internallythreaded.

In accordance with an important feature of my invention, a sleeve orcollar of insulating material 21 is associated with the rear end of theelectrode head and is preferably formed much like a bushing or the like.In Figure 3, the insulating material has a forwardly extending,externally threaded portion 22 adapted to be firmly threaded intoengagement with the skirt 2O previously inentioned. The rear portion ofthe insulating bushing or element 21 is preferably rearwardly beveledand of a diameter slightly greater than that of the metallic portion of'the head 19.

This construction results in an electrode head which is not onlyremovably applicable to the forward end of the electrode stein, but onewhich is extremely efficient in use because of the reduced possibilityof short-circuiting Thus, referring again to Figure 1, the elect-rodehead presents from the exterior thereof a main electrically conductiveportion or body 19 and a rear band or portion 21 of insulating material.In the adjustment and deflection of the electrode within the cavity tobe treated, any contact that may occur will bebetween the defiectingblade 14 and the insulating band 21, and not between the blade 14 andthe conducting portion 19. This is of extreme importance, because in thelateral' adjustment of the electrode head and in the longitudinalshifting thereof to position it accurately in the proper and desiredplace, there is an extreme likelihood of inadvertently causing the blade14 to contact with the rear end of the electrode head.

Referring again to Figure 3, I will point out that I have ensheathcd thecore 15 within a pair of insulating tubes 23 and 24. Each of these tubesis of a flexible and resilient character, preferably of an insulatingniaterial formed by the suitable impregnation with gunior the like of asuitable fabric tube. Each of these tubes is ar complete insulatingsheath by itself, andI have found it of extreme advantage, for reasonspresently to be pointed out, to employ two independent and separatetubes mutually telescoped in the snug manner illustrated in Figure 3. Ihave shown the inner tube contacting at its forward end with. the rearend of a. rearwardly extending stein 25 carried by the connector 16 andexternallythreaded. I have shown the outer tube 24 extending forwardlyall the way to the body portion of the connector 16. The rearwardlyextending externally threaded stem 25 is preferably associated with theouter tube 24 by a screw-threaded engagement, although this notabsolutely essential. It is to be particularly noted that the insidediameter of the head 19, andmore particularly., of the insulatingportion 21, is substantially equal to the exterior diameter of the outerinsulating sheath 24, whereby the application of the head to the stem ofthe electrode will provide a continuous surface of insulation at theexternal point of juncture.

In other words, upon referring again to Figure 1, I will point out thatthe blade 14 may safely be adjusted and maneuvered without any dangerof'contacting with the core 15 or theV head 19 electrically connectedtherewith.

At the rear end of the stem I provide a hollow handle 26 of insulatingmaterial, and mounted within'this ha-ndle'I provide-a binding post 27 ofsuitable character to receive a terminal wire or the like through therear open end 28 of the handle 26. In Figure 3,

the binding post proper is designated by the reference numeral 29'andconstitutes a split construction adapted frictionally to make Contactwith a pin inserted thereinto. Obviously, the binding` post 27 iselectrically connected` with the core 15, and I have illustraactiveelectrode, it follows that the e1nployment of the electrode within thetube 10 produc-es an arrangement much in the nature of an electricalcondenser. The opposite sides of the condenser are the core 15 and thetube 10, and the dielectric of the condenser is constituted of theinsulating sheath v.

around the core 15. It has frequently happened that because of excesscurrent or for other reasons, the insulation has broken down, therebyfrequently resulting in undesired short-circuits, in possible injury andpain to the patient, and obviously in impairment of smooth operation.The breakdown of a condenser dielectric is due in many cases toconducting impurities in the dielectric. By the employment of twoindependent and separate sheaths, the likelihood of such breakdown isgreatly minimized, because the possibility of conducting impurities ofone tube aligning with similar impurities in the other tube is extremelyslight. For this reason, and for other obvious reasons of a similarcharacter, the insulating quality of the multi-layer sheath illustratedby me is much greater than that of a single sheath, even though suchsheath may have the same thickness as the conjoint thickness of thesheaths provided by In Figure 4, I have shown a modified type of head,somewhat longer and thinner than the head of Figure 3. In this case, theforward conductive portion 31 is again provided with a threaded bore 32adapted to receive the forward end of a suitable connector carried bythe stem. In a rearwardly extending skirt 33 is the forwardly eX-tending skirt portion 34 of an insulating collar whose rear portion 35is similar to the portion 21 of Figure 3. In this instance, I have notshown the skirts 33 and 34 mutually threaded but merely held inassociation by friction.

In Figure 5, I have illustrated a further modification of the. head inwhich both the front and rearward portions are of insulating material. Acylindrical body portion 36 of conducting material is provided with athreaded bore 37 at its forward end and a somewhat enlarged threadedbore 38 at its rearward end. Associated with the bore 38 is aninsulating` collar 39 similar to those above described and provided witha bore adapted to receive the forward portion of the stem of theelectrode.

4tion 36.

Mounted'in the bore 37 is a rounded tip 40 of insulating materialpreferably provided with a rearwardly extending, externally threadedstem 41. The outside diameter of the tip 4() is" preferably the same asthat of the body porrIhe head of Figure 5 is particularly advantageouswhere the portion to be treated -with the diathermic current lies insuch a" position that it would be dangerous or undesirable to have theforward portion ofthe electrode head contact with any other portion ofthe body cavity. rlhe headrof Figure 5 is, for example, particularlyadvan" tageous in the treatment by diathermy o the prostate lobes.

It will thus be seen that I have provided an electrode of extremesimplicity and embodying a number of advantageous characteristicsrendering its use not only more efficient from the standpoint ofcurrents employed,'but also more safe. The likelihood of injury or painto the patient and the lil-:e lihood of sliortveircuiting are reduced toa minimum, and relatively large currents may be employed without riskinga breakdown of the insulation. yIt is particularly to be noted thattheheads are removable and hence interchangeable without impairing theinsulating and safety characteristics of the device. It is further to benoted that the application of any head to the connector at the forwardend of the stem will not induce a loosening or breaking of the metalliccore of the stemf this being due to the fact that the threads of theportion 18 spiral in a direction opposite to that in which the wires 15are twisted. Should the head be turned too far, during its application,it will serve to tighten the twist of the wires 15 rather than loosenthem. Y i

It will be obvious that changes in the details vherein described andillustrated for the purpose of explaining the nature of my invention maybe made by those skilled in the art without departinoq from the spiritand scope of the invention as expressed in the'appended claims. It istherefore intended` that these details 'be interpreted as illustrative,and not in a limiting sense.

I-Iaving thus described my invention and illustrated its use, what Iclaim as new and desire to secure by Letters Patent is- 1. For use witha fenestrated endoscopic tube constituting an indifferent electrode, anactive electrode insertable through said tube and out of said fenestra,said active electrode being provided with a head which is partly ofconducting and partly of insulating material.

2. For use with a fenestrated endoscopic tube constituting anindifferent electrode, an active electrode insertable through said tubeand out of said fenestra, said active electrode being provided with ahead whose rearward portion is of insulating material to preventaccidental short-circuiting thereof with said tube.

3L For use with a fenestrated endoscopic tube constituting an indiferentelectrode, an active electrode insertable through said tube and out ofsaid fenestra, said active electrode being provided with a head whoseforvI0' ward and rearward portions are of insulating material.

4. For use with a fenestrated endoscopic tube constituting anindifferent electrode, an active electrode insertable through said tube1"5 and out of said enestra, said active electrode comprising a thinflexible stem with a sheathing of insulation, and an enlarged head whoserearward portion is of insulating material.

'20 5. For use with a fenestrated endoscopic tube constituting anindifferent electrode, an active electrode insertabfle through said tubeand out of said enestra, said active electrode comprising a thinflexible stem formed l of twisted conducting wires, a sheathing ofinsulation around said wires7 and an enlarged head of conductingmaterial attached to the forward ends of said wires.

6. For use with a fenestrated endoscopic '30 tube constituting anindifferent electrode, an

active electrode insertable through said tube and out of said Jenestra,said active electrode comprising a thin flexible stem formed of twistedconducting wires, a sheathing of insulation around said wires, and anenlarged head of conducting material attached to and enveloping theforward ends of said wires, said head being provided at the rear thereofwith an insulating collar.

' 40 7. As a new article of manufacture, an

electrode head for application to a portion of the body, said headcomprising a body of conducting material provided at its rear end withmeans for removably attaching said body to the Aforward end of arelatively thin electrode stem, and said rear end having its exposedsurface formed of insulating material.

In witness whereof I have signed and 50 sealed this speciication this 10day of September 1929.

REINHOLD H. VAPPLER.

